EmailMe Form - GSOC National Delegate Application

Name *

First Last

Email *

Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Service Unit

Have you served as a Service Unit Delegate? *

Yes

No

Have you attended the Annual Meeting of the Delegate body? *

Yes

No

Have you attended a National Convention as a visitor? *

Yes

No

If yes, when and where:

Have you ever been a National Delegate? *

Yes

No

If Yes, when and where:

What volunteer roles have you held at Girl Scouts of Orange County?

Have you earned any GSOC Awards?

Are you a US Citizen (Required by GSUSA Congressional Charter) *

Yes

No

Attendance at a National Convention meeting requires travel, extensive walking, sitting or standing for long periods of time. Do you have any physical limitations of which we need to be aware?

Yes

No

If yes, describe any accommodation you would require. *

We collect the following information for statistical purposes only. Please select all that apply.

Other: Please specify

What is your age group? *

18-29

30-49

over 50

Please supply two references (other than relatives) who qualify to supply additional information about you.
Provide Name, email, phone and relationship *

Why should we consider for this role as a National Delegate for Girl Scouts of Orange County? *

What skills and expertise do you feel you can contribute as a National Delegate? (300 word limit) *

How would you describe the difference between policy making and policy influencing? How have you engaged in both processes in Girl Scouts? (300 word limit) *

How will you engage members of GSOC, both volunteer and girl members, to gather their thoughts and input on meeting agenda items and topics that arise later during your three year tenure? (300 word limit) *

If elected, I agree to commit to the accountability and eligibility requirements of Girl Scouts of Orange County Council Delegate.
By typing my name below, I acknowledge the selection process involves a subjective component and the Council must retain the exclusive right to make decisions most appropriate for the welfare and development of all members. Girl Scouts of Orange County is committed to diversity and inclusion and all applicants will be considered without regard to race, religion, color sex, age, national origin, citizenship, disability, marital status, veteran status or any other status protected by law.
I certify that my answers to the preceding questions are true and complete. I understand that the information is subject to verification. *

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